Qualitative Research Methods for Healthcare Evaluation

 Group Lead: Sheila Greenfield
Deputies: Dr Nicola Gale and Dr Sabi Redwood

This research group brings together all those who use qualitative methods in their research. These methods are often derived from the social sciences and humanities (e.g. sociology, psychology, history, ethics, political science, anthropology, law, geography, development studies, linguistics, literature) and are particularly helpful in illuminating the social, psychological, cultural and political aspects of public health and medicine. 

Qualitative methods are appropriate where research questions can not be answered numerically, perhaps because you want to ask an open, exploratory question rather than test a hypothesis.   Complex systems, context or processes in public health and health care, as well as experiences and beliefs can be captured and explained using qualitative approaches. 

Traditional qualitative research methods include interviewing, participant-observation, focus groups and textual analysis. However, increasingly researchers are making use of novel methods such as art-based approaches, photo-elicitation and film to both collect data and disseminate findings.

Brown Bag Lunches (bring your own sandwiches!)

These meetings take place on the last Friday of every month from 12.30-1.30pm in PCCS 221/224. They are an opportunity for all those doing qualitative research to informally share the work they are doing, to get advice on any challenges they are encountering during their research, or to get feedback on early findings/project ideas from an informed (but friendly!) audience.  We also discuss strategic development of the Research Group within HaPS. For any queries, please contact Nicola Gale

Qualitative Postgrads

This is a group for all research students who are using qualitative methods. The group is coordinated by Sheeba Rosewilliam The group meets regularly after the Brown Bag lunches, from 1.30-3.00pm.

Research group members...

 Qualitative Research Methods for Health Care Evaluation team:

Dr Hareth Al-Janabi 
Miss Christina Anderson
Ms Patricia Apenteng
Dr Cara Bailey
Ms Amunpreet Boyal
Ms Joanne Clarke
Prof Jo Coast
Dr Carol Cummins
Dr Andy Dickens
Dr George Dowswell
Prof Heather Draper
Dr Derek Farrell
Mr Benjamin Fletcher
Dr Nicola Gale
Dr Paramjit Gill 
Dr Sheila Greenfield
Dr Alistair Hewison
Mr James Hodgkinson
Ms Lucy Ingram  
Dr Jonathan Ives
Dr Kate Jolly
Dr Miren Jones
Ms Laura Lord
Dr Jonathan Mathers
Dr Lorraine McFarland
Dr Ruth Mellor
Dr Sue Neilson
Prof Jim Parle
Ms Gill Plumridge
Ms Anna Rajakumar
Dr Duncan Randall
Dr Sabi Redwood
Dr Jonathan Reinarz 
Dr Carolyn Roskell
Dr Andy Shanks
Dr Andy Soundy
Dr Lynda Tait

PhD Students: 

Rachel Adams
Rukhsana Bibi
Elaine Cameron
Alison Cartwright
Amanda Chapman
Sandi Dheensa
Sandhya Duggal
Adrian Gheorghe
Sabrina Grant 
Gemma Heath
Sarah Flanagan
Simon Jenkins
Rosie Kneafsey
Kanta Kumar
Gregory Moorlock
Sheeba Rosewilliam
Nicole Samuda
Dyaa Saymah [dsy@who-health.org]
Cathy Shneerson
Manbinder Sidhu
Cathy Shneerson
Beck Taylor
Gemma Taylor
Rowena Yeats

Training and courses...

The undergraduate medical students receive introductory lectures on qualitative methods, which staff and PhD students can sit in on, with the permission of the module leader. Please contact Dr Jon Ives for further details and dates.

MPH Qualitative Research Methods course
Qualitative Research Methods provides students with the philosophical grounding and practical skills to design and carry out a rigorous qualitative research project that has relevance for public health. Rather than focusing on ‘what works?’, qualitative methods are particularly useful for answering the ‘why?’ and ‘how?’ questions. The course combines lectures, workshops and critical skills development. No previous experience of qualitative research is necessary.

PhD students and staff are eligible to attend this course subject to availability. For further details, please contact the module leader, Dr Nicola Gale

External Courses:

Introduction to Qualitative Interviewing 2 day course.
Oxford University
It was an interesting course on the practical aspects of undertaking qualitative research. It’s useful if you have qualitative methods knowledge but are new to actually conducting interviews. It’s ideal for new qualitative researchers (review by Amun Boyal).
DIPEX courses: http://www.primarycare.ox.ac.uk/research/herg/hergcourses/courses

Synthesis of Qualitative Evidence: A Practical Workshop
Midlands Health Psychology Network at the University of Warwick
Facilitated by Dr Antje Lindenmayer
This course is a 1 day short course suitable for those with a very basic knowledge of qualitative research as a methodology but want to familiarise themselves with how to search for qualitative literature effectively, review and appraise literature. The workshop is split into two sessions, the first half discussing qualitative literature, how / what to search for, provides useful references to guide you when reviewing literature and appraising the evidence and introduction to ‘meta ethnography’. The afternoon session is a hands on practical workshop on how to synthesis qualitative data. Considering it’s only for one day you do walk away with confidence that you can search, analyse and synthesise qualitative literature effectively (review by Sabrina Grant).


 Papers and books recommended by staff (with reviews)

  • Braun, V. & Clarke, V. (2006) Using thematic analysis in Psychology. Qualitative Research in Psychology, 3: 77-101.

    A great overview of thematic analysis, which demonstrates the broad scope and flexibility of this method in the field of Psychology and beyond. The authors outline how to carry out thematic analysis in a deliberate and rigorous way, and present potential errors in the use of this approach (review by Elaine Cameron).
  • Hefferon, K. & Gil-Rodgriguez, E. (2011) Methods: Interpretative phenomenological analysis. The Psychologist, volume 24, part 10 (October 2011), pages 756-759.

    A recent article in the British Psychological Society magazine, The Psychologist, in which the authors discuss implications of the rise in popularity of IPA for both teachers and students. A very clear outline is given of the common pitfalls in producing good IPA studies. Many of the points are relevant for researchers using other methods, or at least causes one to look critically at the conduct and reporting of one’s own research. Also several useful references are provided on demonstrating validity and ensuring quality in IPA research (review by Elaine Cameron).
  • Saldaña, Johnny (2009) The Coding Manual for Qualitative Researchers. London: Sage.

    Affectionately known by my PhD students as ‘The Bible’, this clearly written and well structure guide to qualitative coding and analysis is a must for any budding qualitative researcher (review by Nicola Gale).
  • Jaggar, A.M. (1989), 'Love and Knowledge: Emotion in Feminist Epistemology', in Jaggar, A.M. and Bordo, S.R. (eds.), Gender/Body/Knowledge: Feminist Reconstructions of Being and Knowing, London, Routledge.

    This is an inspiring reflection on how we know what we know, and how we feel what we feel. While emotions feel like the most natural thing in the world, Jaggar explains how even love is structured by social expectations and norms (review by Nicola Gale).

Websites recommended by staff

The Research Ethics Guidebook: a resource for social scientists: http://www.ethicsguidebook.ac.uk/

Economic and Social Research Council National Centre for Research Methods: http://www.ncrm.ac.uk/

Academic disciplines...

A number of different disciplines in the health and population sciences use qualitative methods. These are summarized below:

Medical Sociology
Sociological issues are at the heart of many of the problems our health systems face – at the macro level, health inequalities are remarkably persistent both nationally and internationally, at the micro-level, social interaction is fundamentally important in clinical encounters and can affect the success of treatment. Although, sociologists have used both quantitative and qualitative research methods, qualitative methods are becoming increasingly important to understand complex health systems, and cultural influences on health and illness. Current work in the department including the influence of space and place on health, lay accounts of health and illness and their influence on the uptake of health services, and methodological innovation particularly in ‘seldom heard’ (often termed ‘hard to reach’) groups of patients and the public.
(summary by Nicola Gale)

Health Psychology
Health psychology approach reflects the biopsychosocial model of health and illness developed by Engel (1977, 1980) and claims that illness is not a simple linear model but caused by a combination of biological (e.g. a virus, bacteria and structural defects), psychological (e.g. behaviours - smoking, diet, exercise or alcohol consumption, beliefs, expectations and emotions) and the social aspects of health in terms of social norms of behaviour, values, class, employment and ethnicity. Qualitative methods are therefore an ideal way of exploring patients beliefs, attitudes, opinions, views and experiences about health and illness through the use of number of qualitative approaches: Action research, case studies, discourse analysis, ethnography, focus groups, interviews and feminist approaches. More information: Psychology Special Interest Group (Psych-SIG)  (password protected site)
(summary by Sabrina Grant and Rowena Yeats)

Health Economics
The Health Economics Unit has expertise in using qualitative methods to answer substantive questions with an economic focus, as well as in using these methods in the development of outcome measures. Research has been conducted around substantive questions such as exploring health care rationing/priority setting and the use of economic evaluation methods in decision making, using techniques including interview, focus groups, documentary analysis and observation, with analytic methods focusing on the use of constant comparison and bringing an economic perspective to the analysis. The second major focus of qualitative work within the Unit is around generating attributes for measures of outcome for use in economic analysis and then exploring the use of these measures in practice. Measures that have been developed in this way including the ICECAP measures (www.icecap.bham.ac.uk) and a measure of carer experience, the CES.
(summary by Joanna Coast)

Public Health

History of Medicine
Although one might expect the use of quantitative methods to dominate in the history of medicine given their current predominance in medical research generally, qualitative methods are in fact the norm in this specialist field of historical inquiry. The majority of medical historians, whether working on the eighteenth or twentieth century, collect, analyse, and write about data collected from a small number of people who were neither randomly sampled nor numerous enough to serve as the basis for statistically significant generalizations about the populations from which they are drawn. Historical studies of medical professionals are usually biographical case studies, while patient histories tend to be drawn from personal narratives, such as diaries, not hospital ledgers, and are more concerned with representations of health and illness than curative outcomes. Trends suggest that the predominance of qualitative methods will only continue in this discipline. In the last few years, as more medical history research engages with twentieth-century bio-medicine, despite difficulties accessing medical records, which are usually subjected to a hundred-year period of closure, medical historians are more often able to conduct interviews with their research subjects. More will, therefore, continue to interpret their data in narrative, rather than statistical, form.
(summary by Jonathan Reinarz)

The role of qualitative research in Bioethics is itself a controversial topic, and some work we do in the Centre for Biomedical Ethics involves theorising about the epistemology of integrating ethical analysis and qualitative research. Broadly, qualitative research can be useful to Bioethics in a number of ways, from providing credible empirical evidence in the support of an argumental premise, through helping us to understand the lived reality of bioethical problems, to being fully integrated in the search for a normative solution to bioethical dilemmas. We use a variety of methodologies, and are keen to work with other groups.
(summary by Jonathan Ives)